Sober but Miserable: When Quitting Isn’t Enough

Carl is a soft-spoken screenwriter who grew up in an impoverished, alcoholic home. For most of his adult life, Carl has turned to alcohol to cope with grinding depression and a gnawing sense of not being good enough. One night after a weekend of drinking, Carl had a blackout. He awoke in his car with a horror unlike any other; he believed that he’d hit a pedestrian. He vowed that day never to drink again, and for five long years he didn’t, through sheer willpower. No rehab or 12-step meetings for Carl. But Carl was acutely miserable, prone to angry outbursts and just as anxious and depressed as ever.

Carl’s condition after quitting alcohol, abstinent but miserable, is sometimes referred to as “dry drunk” — an unfortunate term for someone who is able to quit drinking but doesn’t address the issues that fueled the alcoholism. Alcoholics Anonymous has a kinder term for it: two-stepping. Two-stepping describes a person who completes the first and last of the 12 steps while skipping over the deeper, more interior process of addressing underlying issues.

Like Carl, many who quit alcohol do it without help. According to government reports, of the estimated 17 million adults who have an alcohol use disorder, about 66% to 75% will try to quit or moderate their drinking without the help of therapy or a self-help support group, and some will be at least partially successful.

Nevertheless, some who quit without help will be dogged by the same underlying problems that made alcohol so attractive in the first place. And without the calming effects of alcohol, some of these issues can get worse. This group is sober but miserable.

“It doesn’t matter whether you’re addicted to alcohol, overeating, certain kinds of people, or gambling,” wrote the late recovery pioneer Earnie Larsen in Stage II Recovery—Life Beyond Addiction. “What do we have when we take away the object of that addiction? A lot of pain. If you haven’t dealt with your underlying living problems in any focused, consistent manner, pain, pure and simple, will keep you subject to the dry-drunk syndrome.”

Research backs this up. Studies show that the most successful path to lasting recovery is inpatient or intensive outpatient treatment followed by active engagement in continuing care, such as individual or group therapy, 12-step meetings or telephone support, for at least a year. Continuing care builds on the hard work of treatment by encouraging self-exploration and self-knowledge.

Dry-Drunk Terminology

Although the term “dry drunk” is sometimes used as shorthand to describe an assortment of behaviors, it is not recognized as a psychiatric condition by the American Psychiatric Association (APA). Nor is it referenced in any way in the APA’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, which is the standard clinical reference book used by clinicians to diagnose mental health disorders. Nevertheless, most therapists know it when they see it and suggest that the signs of it can signal a downward plunge into relapse. Symptoms include:

Emotional or angry outbursts that are out of character

New behavioral disorders, such as sex/pornography, food, drug, gambling or shopping addiction

Withdrawal from friends and social events

Self-pity; resentment over lifestyle; inability to cope

Lying to oneself or others over destructive or unhealthy behaviors

Denial that there is an emotional problem that needs fixing

Constant negative attitude over normal daily events

Exaggerated self-importance, grandiosity

In truth, many therapists believe that the term “dry drunk” is pejorative and discounts the hard work of achieving abstinence. “As a therapist, I see a lot of people who would be doing really well if they could reach that stage [of abstinence],” says Jeff Browning, a primary therapist for The Ranch in Nunnelly, Tennessee. “People die from alcoholism, so if you’re a dry drunk at least you’ve made some progress.”

There’s a better way to look at it, he says. “They’ve done some really good work to maintain their sobriety but still have some work to do, which is true of every human being that I know.”

The term is also seen by some as an oversimplification of a complex problem. “I really do think that anybody with any amount of sobriety has been a dry drunk at one time or another,” says Browning. “It just means that they are a human being; not perfect.”

Are You Abstinent but Miserable?

If you have quit drinking without the help of a program or therapist and are experiencing as many or more emotional or behavioral problems as before, there are a number of things you can do to ease the transition. You may want to:

Seek help — Join AA or some type of self-help group; if 12-step programs aren’t appealing, find a non-12-step program; find an experienced therapist to help get at the root of the substance abuse; consider going to rehab if necessary.

Get going — Find substitutes for drinking that you enjoy; develop new hobbies or rekindle former interests; attend to yourself, which might include getting more exercise and eating healthy food, as well as spending time outdoors.

Adjust thought processes and expectations — Understand that your life is now different; create a new normal, since life will not be as it was while drinking; mentally redefine your relationship with alcohol.

Develop emotional resilience — Be open to new ideas and to feedback; learn to sit with uncomfortable feelings, such as discomfort, anxiety or depression until the feelings pass.

If your loved one is abstinent but miserable, it’s tempting to turn a blind eye and hope that it gets better. After all, they’ve done the hard work of quitting. Nevertheless, it’s important to address it, says Browning. “My advice to loved ones is to tell the truth, in a nonjudgmental way, even if it’s uncomfortable; be honest with them and let them know that their work isn’t done.”

Slaying Those Dragons

By quitting alcohol, Carl had made a courageous first step, but he couldn’t shake the emotional turmoil that had made alcohol such a good and trusted friend. He resumed drinking, and over the years has tried to moderate his drinking, but he continues to suffer from anxiety and depression and to act out in destructive ways. Carl may one day seek help or he may always struggle with his demons, but most important, he has said that he knows there’s plenty of work to do.

“I’m in recovery myself,” says Browning, “and part of my recovery has been to stop trying to think that people need to be perfect to be in recovery, or even that I need to be perfect. There are many paths to recovery as long as people realize that there’s room to grow.”

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